There is an epidemic of substance abuse within the Puyallup Reservation that has resulted in a skyrocketing number of fatal overdoses over the past three years. To combat the devastation caused by substance abuse within the community, the proposed project seeks to increase access to medication-assisted treatment, recovery housing, and supportive services for Puyallup Tribal community members with chronic or severe opioid use disorder.
The Puyallup Reservation is highly urbanized and is among the most densely populated areas in the State of Washington. The Tribe's Indian Health Services designated service area has a Native American population of 28,208 individuals. In 2021 the Puyallup Tribe's Community Family Services program made referrals for substance and alcohol abuse treatment for 243 individuals. Of those, 59% reported that opiates were the primary substance. Due to COVID-related closures in 2021 it is more accurate to note that in the first two quarters of 2022 alone CFS has already served 191 individuals.
CFS currently offers Suboxone MAT, but is requesting funding for Sublocade MAT. There is evidence that Sublocade is successful at improving outcomes for individuals who have not been successful with other forms of MAT. This intervention is most appropriate for the Puyallup Tribal population because it can increase duration of treatment. Multi-generational trauma within the Native American community has resulted in home and life situations that can be unstable. CFS participants often have chronic OUD and come from families with multiple individuals experiencing severe OUD.
This project will incentivize remaining in the recovery community by providing no-cost recovery housing. In addition, CFS will increase community reinforcement by offering at least two trainings per year on adverse childhood experiences, social determinants of health, and recovery community. Educating CFS staff, peers, and tribal members will increase understanding, reduce stigma, and guide future planning.
The total number of individuals served by the end of the project depends on the length of time participants engage with services, but at a minimum services will be provided to 40 unduplicated individuals. The anticipated number is based upon CFS being able to provide MAT immediately. As a result, the time frame and number served are the same in both years.
The cost of MAT will depend on dosage and length of time prescribed, as well as participant engagement. Based upon the proposed budget no less than 20 people per year will receive Sublocade. The cost of supportive services that are provided with this project, including housing, communication, and transportation will depend on the varying cost of recovery housing. as well as the length of time they remain housed.